Active NPI
Gina Lynn Ibarra, LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1275837015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 65954
- Practice address
- 6609 Blanco Rd Ste 157
San Antonio, TX 78216-6157 - Phone
- (210) 884-0365
- NPI assigned
- Jan 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 65954 | TX | Primary |
Addresses
Primary practice location
6609 Blanco Rd Ste 157
San Antonio, TX 78216-6157
Mailing address
429 Hortencia
San Antonio, TX 78237
Phone (210) 884-0365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240213003466 | TX | Practitioner - Mental Health Counselor | 4183067572 | Practice locations: San Antonio, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1275837015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 HORTENCIA",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78237",
"telephone_number": "210-884-0365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6609 BLANCO RD STE 157",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782166157",
"telephone_number": "210-884-0365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA",
"first_name": "GINA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "65954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.